drugs don't work

The Drugs Don't Work -

Factory Farming's Threat to Human Health

Edited by Clare Druce (Farm Animal Welfare Network)

CONTENTS :

Foreword by Tim Lang, Professor of Food Policy, Thames Valley University	Notes Accompanying the Video 'The Drugs Don't Work'	The Discovery of Antibiotics	How are Antibiotics used, in Animal Food Production?	Are Humans and Animals Resistant to Antibiotics?	Why the Present Concern about Antibiotic Resistance?	Did We Have 'Fair Warning' of the Dangers to Come?
Surely the Situation has Improved?	The Eleventh Hour?	Do We Really Need to Worry?	Recent Warnings and Recent Recklessness, Home and Abroad	How Have Governments Reacted to the Dangers in Recent Years?	Farmed Fish	Does the Main Danger come from the Bugs Themselves, or from Antibiotic Residues in the Food Chain?
Are Vegetarians and Vegans 'Safe' ?	How Many Animals are Kept Together, on a Typical 'Factory Farm'?		The Scope of this Booklet	Appendix - Evidence of Resistance is Emerging	Suggested Topics for Debate for Teachers Using this Booklet in Schools and Colleges	Suggestions for Further Reading

The Drugs Don't Work -Factory Farming's Threat to Human Health

Foreword - by Tim Lang, Professor of Food Policy, Thames Valley University.

I welcome this video. The use of antibiotics has for too long been one of those issues in food and health circles which rumble on, but which hardly ever seem to change. Even the arguments have at times seemed to be locked in a loop. All that is changing.

In one corner, proponents of antibiotics have argued that without them, both animals and humans would return to the nasty short lives of yesteryear. Antibiotics, they say, are a cornerstone for modern efficient farming. For humans, they are essential. (1 confess some interest here; my life was saved once by antibiotics, and my arm would have been amputated on another occasion without them, as a child in India.)

In the other corner are those who find antibiotics unnatural, inappropriate, dangeous and symbols of intensive farming which (at its worst) threatens the ecosphere.

How can we make sense of these opposing positions? Firstly, fact must be sorted from fiction. This is easier said than done. The critics lack laboratories and support. The proponents are aware they fall foul of the 'they would say that, wouldn't they!' test. Everyone smells conspiracies. But, suddenly, the seeming impasse is altering. The impetus for this change is ironically not animal welfare which has been the subject of so many inquiries by scientists and policy-makers and of so much education and campaigning by non-governmental organisations. No, it is human health which is breaking the logjam.

A statement from the recent Chief Medical Officer of Health, before he retired, brought to a head growing medical concern about the health threat from antibiotic over-use. This position is now in the ascendancy on both sides of the Atlantic. Two problems are now being identified - excessive use by GPs (and patients demanding they get a pill) and prophylactic use on farms. Science seems to be edging in the favour of greater control on antibiotic use.

The second factor is public opinion. After nearly two decades of scandals and debate about the food system, a big policy choice looms. Over half a century's intensification of agriculture is now in the spotlight. BSE undoubtedly brought it to a head. Scientific support for intensive farming has received a rude awakening. Scientists are chastened. Their views are only some among many. In addition, science itself has to be questioning. Good science is independent and should not be slavish to commercial interests. It ultimately has to serve rather than make public policy.

Farmers have been bemused by this questioning. Was it not the public, as well as politicians, which urged them to produce cheap food? It was. Yet, now the methods of this intensive production system, from pesticides and fertilisers to plant breeding and antibiotics, are on trial. Animal husbandry is set to change.

Ironically, just as it was Labour which had to unravel the century's experiment with free trade after World War II, so it is Labour again today which has the historic opportunity to set the tone and direction for national food policy. Will it help turn the good ships British and European Agricultural Policy away from their continued drive for efficiency? Will it not set the 'level playing field' at a plane where both producers and consumers can be happy with what is produced? Will it prevent global trade agreements from ruling animal welfare issues 'non-scientific', and therefore barriers to trade which ought to be dismantled? These are big policy questions which loom.

This video is hard-hitting. It will not appeal to some, but the case it makes has to be heard. Even if you do not agree with it, please remember that its case is now definitely on the policy map. The truth is that factory farming relies on antibiotics. The truth is that in food markets where farmers in different countries are set on a ruthless treadmill of competition with each other, the pressure to produce cheaply is ratcheted up.

Things do not need to be like this. It is possible to farm and produce food in more acceptable ways. If we want to reserve antibiotics for the occasions when they truly make the difference between life and death (I type this with my arm that would have been amputated but for antibiotics) their over-use must be curtailed. If we want to do that, then factory farming has to be phased out.

Personally, I see a 'win win' situation here. We will not see our way out of the impasse unless we recognise that everyone and everything has to change. I am a critic of current factory farmed food production. I nonetheless recognise the logic that keeps those who have invested heavily in intensive farming on that treadmill. They cannot have it both ways, professing they believe in producing what the customer wants but in fact saying we can only have it this way. Equally, the public has to change too. It cannot demand ever cheaper food and then dislike the squalor and implications of the intensive production systems.

The message of the video is sobering. Ponder on it. Enter the debate. Ask yourself: are your messages clear? Can we really afford to carry on in this way? If intensive agriculture is to change, we have to help it change, not just berate it when things go wrong. That way, I think and hope we can collectively make the transition from blind consumerism to a more responsible citizenship. We do, after all, eat the food. Maybe we should ponder more as we munch. I think more and more people are doing just that.

Tim Lang, Professor of Food Policy, Thames Valley University. November 1998

Notes Accompanying the Video "The Drugs Don't Work'

Notes to accompany the video The Drugs Don't Work, produced by the Farm Animal Welfare Network and the National Society Against Factory Farming, Autumn 1998

It is no coincidence that the development of intensive (or 'factory') farming has gone hand in hand with the discovery and development of antibiotics. Animals kept in close proximity to one another, often in large numbers and unhealthy and stressful conditions, could not survive at an economic level without the 'prop' of antibiotics.

THE DISCOVERY OF ANTIBIOTICS

1 ) The effectiveness of antibiotics for fighting infection was discovered by Fleming and developed by Florey. Antibiotics were first used in human medicine during the Second World War.

2) Penicillin was the first antibiotic to be introduced.

3) Broad-spectrum antibiotics are active against a wide range of pathogens. Narrow-spectrum antibiotics are active against specific groups of microorganisms.

HOW ARE ANTIBIOTICS USED, IN ANIMAL FOOD PRODUCTION?

They are used in three ways:

4a) Therapeutically.

This is when antibiotics are used to treat already sick animals.

4b) Prophylactically

i) to prevent or to control anticipated disease in healthy animals, either given in feed or water, or administered by injection in specific situations where infection may occur, for example after a difficult lambing.

ii) routinely, to prevent or control 'diseases of intensification'. Pigs and poultry housed in crowded sheds are highly susceptible to infection.

iii) when dairy cattle are 'dried off' antibiotics are inserted into the teats of the udder to combat mastitis. (Dairy cows are 'dried off' for a few weeks before their next calving - i.e. they are no longer milked, and the milk supply ceases until the calf is born.)

4c) To promote growth and improve feed conversion

These antibiotics are not generally used in human medicine. Originally it was thought that these 'non-therapeutic' drugs would cause no problems in human medicine (i.e. problems of drug resistance) but it's now known that their use has contributed to the spread of antibiotic-resistant strains of bacteria which can endanger the human population. Growth promoting antibiotics (sometimes called 'performance enhancers' and distinct from growth hormones) are used very widely in the intensive pig and poultry industries, and added to the feed of calves and beef cattle.

ARE HUMANS AND ANIMALS RESISTANT TO ANTIBIOTICS?

5) No, it is the organisms themselves that 'learn' to become resistant to the drugs used to combat them.

WHY THE PRESENT CONCERN ABOUT ANTIBIOTIC RESISTANCE?

6) In the past, new antibiotics could be introduced, to take the place of those that were losing their effectiveness. But now the alternatives are running out. No genuinely new antibiotics have been developed for over twenty years and no new ones are expected to be available for 5-10 years.

7) However, it could be said that the authorities have been very slow in acting to avoid the trouble that was certainly in store.

DID WE HAVE 'FAIR WARNING' OF THE DANGERS TO COME?

8) As long ago as 1968 the relevance to human health of (non-typhoid) Salmonellae resistant to antibiotics was reviewed (Anderson, 1968) following the development of multiresistance in the strain of Salmonella which was causing much of the food poisoning at that time.

9) This serious threat to human health was one factor leading to the setting up of the Swann Committee, whose role was to influence government policy on antibiotic use.

10) In November 1969 the Swann Report was published, making clear the dangers from the careless use of antibiotics: 'In systemic infections antibiotic therapy may be life-saving and the treatment may be made more difficult or the patient's life even imperilled because of antibiotic resistance. We accept that this has already happened and we have no doubt that it could do so again ...' (Swann Report, Chapter V, 8.9) 'in the long term we believe it will be more rewarding to study and improve the methods of animal husbandry than to feed diets containing antibiotics.' (Swann Report Chapter IX/Discussion and Proposals) It could be said that the present dangerous situation has come about because this reasonable and wise proposal was totally ignored.

11) In fact, the Swann Committee recommendations have failed to safeguard human health in a major way. A prime example of the failure is illustrated by AVOPARCIN/VANCOMYCIN (see Appendix). Originally used as a growth promoter, and not in human medicine, avoparcin (the drug whose equivalent in human medicine is vancomycin) was very widely used since the earliest days of antibiotic growth promoters. As the years went by, more and more 'bugs'became resistant to the antibiotics being used to overcome them, and antibiotics not originally intended for human medicine were brought into use, but still allowed in farming. Thus the division between therapeutic and non-therapeutic drugs, and veterinary and medical drugs, was blurred to the extent that it's now meaningless. Growth promoters, used to maximise profits, now endanger human life. Despite the recent EU ban on avoparcin, it is still widely used in countries outside the EU. Consequently, antibiotic residues may be present in imported chicken, and (more dangerously) MRSA resistance to vancomycin may become common worldwide (see Appendix).

12) An earlier and highly significant landmark was the publication of Ruth Harrison's Animal Machines (Vincent Stuart Ltd, 1964) which effectively exposed the unhealthy and cruel aspects of the new farming methods. (The foreword is by Rachel Carson, whose book Silent Spring alerted the world to the dangers of pesticides). Mrs Harrison sounded alarm bells about the dangers of antibiotics: 'We would seem to be placing a very heavy burden of responsibility on the farmer and the feed manufacturer; their chief concern is with rapid feed conversion but how much do they really know of the ultimate effect on the human consumer of all the drugs they use?Yet, for example, feeding firms are entitled to incorporate up to 100 grammes of antibiotic in each ton of animal feeding stuffs as a regular supplement for intensively kept animals, and the farmer may buy and incorporate antibiotics at any level he thinks fit.'

13) The Swann Committee did succeed in promoting a clear division between the therapeutic and non-therapeutic antibiotics (the latter being growth promoters) and many (but not all) of the drugs 'shared' by doctors and vets became available for use with animals only on prescription by a veterinary surgeon. These are described as Prescription Only Medicines (POMs). Given the nature of modem farming methods there has been a routine need for these 'prescription only' antibiotics.

BUT SURELY THE SITUATION HAS IMPROVED, THIRTY YEARS ON?

14a) The 1997/98 Handbook of Medicinal Feed Additives describes many of the drugs currently available for inclusion in the feed/water of farm animals and farmed fish. Their active ingredients would be familiar to all doctors, and to patients who study the labels on the drugs prescribed to them. Many lifesaving drugs are given routinely to animals simply to counteract the squalid conditions endured by millions of animals throughout the world.

14b) 'Recently, multiresistant S. typhimurium phage type DT104 has been reported with increasing frequency in several coutries worldwide. (Threlfall and others, 1994; Almut and others, 1997; Besser and others 1997; Low and others, 1997). These isolates are resistant to ampicillin, chloramphenicol, streptomycin, sulphonamides and tetracycline, but have also showed a tendency to acquire resistance to additional antimicrobial agents.' (Threlfall and others 1996, Veterinary Record, v. 143, no. 4, 25 July 1998, p. 95)

14c) A letter published in Veterinary Record (v. 142, no. 10, 7 March 1998) illustrates clearly the connection between the use of the same drugs on human and animal populations. The authors note the 'marked increase' in isolations of Salmonella typhimurium (DT) 104, making it the most prevalent salmonella in humans in England and Wales after Salmonella enteritidis phage type 4. In 1996, 4006 isolates of DT104 from humans were identified in the Public Health Laboratory Service's Laboratory of Enteric Pathogens compared with only 259 in 1990 (Threlfall and others, 1997). Of these, 95% were multiresistant to antibiotics. The letter states: 'The primary food animal reservoir of multiresistant DT104 is cattle, although since l993 the organism has become increasingly isolated from other food animals, including poultry, sheep and pigs.' The link is made between veterinary use of enrofloxacin, licenced for veterinary use in the UK in 1993, and the emergence and spread of isolates of multiresistant DT104 with reduced sensitivity to this drug (a fluoroquinolone ~ see fact 24a-c). Serious increases in multiresistant strains of salmonella are noted in the USA, but the authors draw attention to the continued effectiveness of fluoroquinolone antibiotics in that country, for the treatment of humans, commenting that this is: 'probably due to the continued restriction of fluoroquinolones in the USA, where the only approved veterinary usage of these antibiotics, granted in late 1995, is in poultry' and conclude: continued restriction of the veterinary use of fluoroquinolones in the USA and vigilant surveillance for the emergence of fluoroquinolone resistance in zoonotic salmonellas appears warranted.' (Threlfall, UK Central Public Health Laboratory. Angulo, Centers for Disease Control and Prevention, Foodborne and Diarrheal Diseases Branch, Atlanta, Georgia, USA. Wall, Communicable Disease Surveillance Centre, London.) Given the massive and highly intensive nature of the USA's poultry industry, it seems reasonable to predict a huge rise in S. typhimurium resistant to the fluoroquinolones by the millenium.

METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA)

15a) MRSA is a serious and sometimes fatal infection associated with cross-infections in hospitals. As long ago as 1989 The Lancet published an article highlighting the worrying and increasing ineffectiveness of many antibiotics previously useful in combatting MRSA. They noted geographical patterns of resistance: 'MRSA from the UK and Australia were predominantly resistant to trimethoprim ...' Trimethoprim has been widely used in the UK poultry industry, as have many of the other antibiotics listed as becoming useless against MRSA. ('World-wide antibiotic resistance in methicillin-resistant Staphylococcus aureus', Maple, Hamilton-Miller, Brumfitt, Dept. of Medical Microbiology, Royal Free Hospital School of Medicine, London, The Lancet v. 1, 11 March 1989)

15b) Professor Brian Spratt, addressing a meeting of international specialists in London on 23 May 1997, was reported as warning: 'MRSA is an aggressive infection and can be life-threatening in hospitals. There is a real worry that if vancomycin [resistance] moves into MRSA there will be no way to treat those who are infected. If this happens, the consequence is likely to be that people will die from post-operative infections. If this organism becomes common in hospitals, many surgical advances will be halted. This is a major worry.' (The Guardian, 24 May 1997) Researchers at the conference warned that vancomycin-resistant strains of Staphylococcus aureus were already emerging in Japan, where antibiotics are widely used. (Japan has little farm land, and all its egg production is intensive; fish farming is also developing fast in Japan, with the accompanying 'need' for antibiotics.)

WHAT IS VANCOMYCIN?

16) Vancomycin is an important drug of 'last resort' in human medicine. It is a member of a group of antibiotics called glycopeptides and is almost identical to avoparcin.

17) Avoparcin was banned in 1997 throughout the EU, despite opposition from the UK. Avoparcin was marketed under the brand name 'Avotan', and available without a veterinary prescription.

THE RECKLESS USES OF THIS HUMAN DRUG OF LAST RESORT!

18) 'Avotan' was recommended for increasing milk production, and for growth promotion (more readily described as 'performance enhancing' by the drug companies) in pigs, broiler chickens, turkeys and calves - animals being pushed beyond their biological limits and forced to grow at unnatural rates, fed this most vital antibiotic! The benefits gained by the farming industry may ultimately be far outweighed by the disastrous consequences of mass medication for increased profits.

THE ELEVENTH HOUR?

19) A few cases of MRSA which are resistant to vancomycin have already been reported, worldwide. If this resistance should become common in MRSA, then all known antibiotics would be useless against this life-threatening condition. Please see Appendix 1 for the article 'Evidence of resistance is emerging' by Richard Young, Living Earth, no. 199, July-Sept. 1998, re-printed by kind permission of the Soil Association.

HAVE SOME COUNTRIES ACTED TO AVERT THE DRUGS CRISIS?

20) In a letter to FAWN (dated 18 September 1998) the Veterinary Medicines Directorate (VMD) wrote:'... Denmark, Finland and Sweden have provided information in support of unilateral bans on certain antibiotic feed additives and the European Commission is consulting its independent Scientific Committee on Animal Nutrition (SCAN). The SCAN's reports will be considered in the Standing Committee for Animal Feedingstuffs. The Government will support the outcome of the Standing Committee's deliberations, provided that it is based on sound science.'NB The unilateral bans mentioned in this letter refer to bans on growth-promoting antibiotics, and not therapeutic ones.

21a) In November 1998 the European Commission proposed a ban on four of the existing eight antibiotic growth-promoters - spiramycin, bacitracin zinc, tylosin phosphate and virginiamycin while placing the other four under review. If EU agriculture ministers agree to the ban, it could be enforced throughout the EU from the beginning of 1999.

21b) A spokeswoman for the National Farmers Union (NFU) commented: 'Antibiotics in this country have brought enormous benefits for animal health and welfare over many decades and we have not seen any scientific evidence of the transfer of resistance to humans'. (The Guardian, 13 November 1998)

21c) Animal welfarists are concerned that a sudden ban on growth-promoting antibiotics could lead to an even greater use of therapeutic drugs, i.e. those more likely to have a direct adverse effect on human health. (Growth-promoters appear to have a beneficial effect in the prevention of certain infections in farm animals.)

21d) In Sweden, where antibiotics for growth promotion have not been used since the mid-1980s, there was an initial rise in the need for antibiotics to counteract infection. However, '... Sweden has already shown that this increase in infection could be prevented by better management...' (MAFFs Review of Antimicrobial Resistance in the Food Chain, p. 131)

21 e) Welfarists believe that without fundamental changes in livestock husbandry systems veterinarians may prescribe yet more therapeutic antibiotics for prophylactic use, thus increasing existing problems of resistance. The urgent need is for a ban on all systems which fail to take account of the physical and emotional needs of farmed animals (including fish).

BUT DO WE REALLY NEED TO WORRY?

22) Currently, many organisms harmful to humans are multi-resistant to a large and increasing range of antibiotics. If the worst fears of concerned doctors/scientists are realized, we may be entering the 'post-antibiotic' era, when even seemingly trivial infections (from an insect sting, or a mild burn, for example) could prove fatal, without the help of antibiotics.

DO ANTIBIOTICS HELP IN ILLNESSES CAUSED BY VIRUSES?

23) Antibiotics are not effective against viral infections, but may save lives threatened by the secondary infections that often follow viral infections. Farm animals frequently suffer from post-viral infections such as sinusitis, infectious bronchitis and septicaemia. These conditions are usually treated with antibiotics, for ezample amoxycillin, trimethoprim, enrofloxacin - all vital to human medicine.

RECENT WARNINGS AND RECENT RECKLESSNESS, HOME (UK) AND ABROAD

24a) Enrofloxacin is one of the fluorinated quinolones, a group of antibiotics now introduced into veterinary medicine.

24b) In 1989 veterinary sales of enrofloxacin accounted for 50% of the sales of all fluoroquinolones in human medicine in the Netherlands. In a letter to The Lancet (v. 335, 31 March 1990 p. 787) scientists from microbiology and public health departments in the Netherlands wrote to express concern that the introduction of enrofloxacin to veterinary medicine (just three years previously) may already have resulted in a dangerous new strain of antibiotic-resistant campylobacter. The letter concluded: 'If large-scale use of quinolones in veterinary medicine does lead to a rapid increase in resistance among campylobacter, the use of these drugs for treatment or prophylaxis of bacterial diarrhoea will meet with failure, so our findings may have important clinical implications.'

24c) In the same year, a letter in The Lancet (v. 336, 14 July 1990, p. 125) from doctors from the UK's Birmingham University, Birmingham's Dudley Road Hospital and MAFF's Veterinary Laboratory, Weybridge, expressed the same fears: 'Thought needs to be given as to whether quinolones, such as enrofloxacin, should be given to animals'.

WHAT IS CAMPYLOBACTER?

25) The campylobacter organism causes more food poisoning in the UK than the various Salmonellae. Raw and undercooked poultry are notorious vehicles of infection. This form of food poisoning results in distressing symptoms including severe abdominal pain (sometimes confused with appendicitis), bloody diarrhoea, and sometimes seizures. Long-term ill effects may be experienced, including reactive arthritis.

TRIMETHOPRIM

26a) 'Resistance to trimethoprim is worrying because cotrimoxazole is an efficient and inexpensive alternative for the treatment of typhoid fever due to chloramphenical-resistant Salmonella typhi.'(Letter to The Lancet, v. 336, 28 July 1990, p. 252)

26b) Trimethoprim is used widely in both human and animal medicine. On farms it is prescribed for conditions such as infectious sinusitis in poultry and atrophic rhinitis in pigs (a disease in young pigs which may result in severe deformation, or even partial loss, of the snout). Both the above illnesses are typical 'diseases of intensification', that is diseases encouraged by conditions in intensive units (overcrowding, poor ventilation, stress etc.).

DID THE VETERINARY MEDICINES EXPERTS HEED THE WARNINGS?

27a) Unfortunately, they did not. Very soon after concerns were expressed in The Lancet, it was announced that '... an animal test certificate (ATC) has been issued permitting enrofloxacin (Baytril 10 per cent solution; Bayer) to be used under controlled conditions in turkeys, chickens, pigeons and psittacine birds.' (Veterinary Record, 30 March 1991, letter from J.M. Rutter, Veterinary Medicines Directorate, Weybridge)

27b) Bayer now distributes enrofloxacin (under its trade name Baytril) 'widely', according to a spokesman for Bayer. (Information given to FAWN, September 1998)

WHAT STAND HAS BEEN TAKEN BY THE UK VETERINARY PROFESSION AND MAFF OVER THE LAST DECADE?

28) The veterinary profession: 1989

The Medicines Committee of the British Veterinary Association (the BVA) published a briefing document to help vets with the thorny question of antibiotic use, entitled Animal Use of Antibiotics. Vets were told that 'although resistance can be transferred from animal to human bacteria and vice versa in vitro there is little opportunity for this to occur in vivo' (page 22). (In vitro = in laboratory conditions; in vivo = in a living organism)

Under the heading 'IS THE PUBLIC RIGHT TO BE CONCERNED ABOUT THE WAY IN WHICH ANTIBIOTICS ARE USED?' the author/s of the document conclude: 'The emotive statements made in the news media often confuse the public. It is hoped that the Questions and Answers provided in this booklet provide veterinary surgeons in practice and elsewhere with sufficient information to counteract incorrect publicity, and to reassure their clients and the public that antibiotics are vital for the health and welfare of animals; for the efficient production of farm animals which is necessary for producing cheap food, that there are 'checks' for antibiotic residues, that residue violations are very infrequent, and that we are not sitting on top of a 'super bug" time bomb. Antibiotics have been used in man and animals for nearly half a century to the great benefit of both and with little risk to either.'

NB Statutory 'checks' for antibiotic residues in poultry meat were not introduced until 1998, to bring the UK in line with EU Directive 9623. Statutory checks on red meat came around a decade earlier.

29) 1998 (June)

The VeterinaryRecord's 20 June 1998 issue examined, in its editorial 'Comment', the question of the contribution that antibiotic use in animals may be making to resistance to drugs used in human medicine. At no point in VR's Comment was any mention made of the conditions in modern farming that lead directly and often inevitably to diseases necessitating the frequent and often routine use of antibiotics, both therapeutic and non-therapeutic. This despite the fact that the phrase 'diseases of intensification' was presumably coined by the veterinary profession itself.

30) 1998 (September)

The Veterinary Record reported on the European conference on antimicrobial resistance, held in Copenhagen on 9/10 September. Again, the connection between squalid housing for farm animals and disease seems to have been missed*, but the seriousness of the situation was apparent. A document was drawn up following the proceedings, dubbed 'The Copenhagen Recommendation' which stated: 'It is thus essential to introduce policies on the rational use of antimicrobials to avoid further increases in resistance.'

HOW HAVE GOVERNMENTS REACTED TO THE DANGERS, IN RECENT YEARS?

31) In June 1991 David Maclean, Parliamentary Secretary to the then (Conservative) Minister of Agriculture, wrote to William Benyon, MP (following a letter Mr Benyon had received from a concerned member of the public): 'on antibiotics, the Veterinary Medicines Directorate has made a careful evaluation over the years of the question of their unsuitability for veterinary treatment, and which ones can be used safely without posing any kind of threat to human health, whether by causing resistance to those antibiotics used in human medicine or otherwise.'

32) Before the 1997 general election, Tony Blair comissioned a report for the planned Food Standards Agency -'An Interim Proposal' by Professor Philip James, Director of the Rowett Research Institute. The Interim Proposal was dated 30 April 1997, and stated:'There will be a need for close links between the new Veterinary Public Health unit of the Agency and the veterinary medicines review process. The rapid emergence of such widespread antibiotic resistance is evidence that there is a great need to alter veterinary, as well as medical, practice to prevent the inappropriate use of veterinary medicines.'Comments were invited on the Interim Proposal, and the Farm Animal Welfare Network (FAWN) stated its belief that no substantial improvement would be possible without radical changes in animal husbandry methods first taking place.

*The need for 'better farming practices' was mentioned, but not elaborated upon, at least in the pages of VR.

33) In January 1998 the Food Standards Agency's White Paper 'A Force for Change' was presented to Parliament by the Ministry of Agriculture, Fisheries and Food by command of Her Majesty. With reference to pesticides and veterinary medicines, it's stated that the Agency will: '... participate fully in the authorisation/licensing processes, will be consulted in policy, legislation and EU negotiations and will have powers to carry out its own surveillance for residues' and, in Chapter 4 para 32: 'As in other areas, the Agency would be able to make public any concerns it had about the Government's decisions and actions on pesticides and veterinary medicines. This freedom to publish its views will give it considerable influence in its dealings with PSD and VMD.' (PSD = Pesticides Safety Directorate, an Executive Agency of MAFF; VMD = Veterinary Medicines Directorate, an Executive Agency of MAFF responsible for licensing and control of the manufacture and marketing of veterinary medicines, for the surveillance of residues in animal products, and for the monitoring of suspected adverse reactions to veterinary medicines in animals and humans.)

34) The problem of antibiotic resistance would appear to be given a low profile, at least in this White Paper, despite the urgency of the situation.

35) 1998 (July)

The Ministry of Agriculture, Fisheries and Food (MAFF) published A Review of Antimicrobial Resistance in the Food Chain. This Technical Report is based on research carried out by teams of advisors from UK medical and veterinary centres and the conclusions of a workshop held in Birmingham in October 1997, which involved the original investigators, MAFF, and experts in the field of antimicrobial studies from the UK, Europe and the United States. On the fluoroquinolones, the Review concludes: 'There is genuine concern over the development of resistance to fluoroquinolones in animal bacteria and the subsequent infection of humans with the resistant bacteria. Most concern arises over salmonella and campylobacters, particularly in the use of the product in poultry which is a significant source of resistant organisms ... practices such as egg injection and the perfectly valid use of the product for the treatment of colisepticaemia in poultry may be contributing to this rise in resistance.'It must be asked - is the use of this drug 'perfectly valid' given that unhealthy conditions on intensive farms lead directly to the 'need' for the present reckless and widespread use of antibiotics?

FARMED FISH

36) Fish with such pleasantly evocative names as'Atlantic salmon' and 'rainbow trout' are intensively farmed, in increasing numbers. As with other factory-farmed animals, stressful and overcrowded conditions promote disease. Broad spectrum antibiotics may be added to pelleted feed. One drug company warns, in its literature: 'Recent knowledge suggests resistance to antimicrobials in aquatic situations appears readily.'New and untreatable diseases among farmed fish are now emerging; diseases can be transferred from farmed fish to those living naturally in rivers and seas.

DOES THE MAIN DANGER COME FROM THE BUGS THEMSELVES, OR FROM ANTIBIOTIC RESIDUES IN THE FOOD CHAIN?

37) The risk from antibiotic residues in food may be slight. Some antibiotics are destroyed by cooking. The greater problem arises when antibiotic resistant bacteria are selected by the antibiotics given to farm animals which are then passed down the food chain, as is happening with salmonella and campylobacter.

ARE VEGETARIANS AND VEGANS 'SAFE'?

38) No,because antibiotic-resistant bugs may be 'caught' via means other than eating meat etc. A vegan could become infected with an antibiotic-resistant strain of, say, salmonella, from being in close contact with a sick person. It's also possible to suffer from salmonella via contact with infected air, or soil. Fans which extract air from intensive units spread infected air over surrounding areas, and slurry and used litter can harbour salmonella, campylobacter and listeria organisms for months. Pathogens can also survive on clothing, furniture etc. so small children (who tend to investigate their surroundings orally) can be at risk.

HOW MANY ANIMALS ARE KEPT TOGETHER, ON A TYPICAL 'FACTORY FARM'?

39) A typical modern turkey unit/shed will contain up to 25,000 birds. A large farm may have several units of this size on one site.

40) Broiler (meat type) chickens may number 50,000 in each 'flock'. As with turkeys, farms hold several sheds, so one 'farm' may have half a million chickens on its premises.

41) A modern battery shed could house 50,000 birds, caged in groups of four or five birds per cage. Again, most battery egg farms hold several units.

42) Hundreds of pigs may be housed together, and dairy farmers keep their cattle indoors throughout the winter, often in conditions which 'invite' disease.

43a) Present MAFF stocking densities for turkeys and broiler chickens are as follows:

43b) TURKEYS (in broiler-type housing, which accounts for around 85% of all UK turkey production)

260 cm square per kg (equating to a maximum stocking density of 38.5 kg/metre squared). In visual terms, turkeys nearing slaughter weight live 'shoulder to shoulder' in intensive farms.

Turkeys are marketed at a wide range of weights (5 kg-20 kg) according to the Farm Animal Welfare Council's 1995 Report on turkey welfare (para 67). FAWC noted that some turkeys on farms visited in connection with the 1995 Report were stocked at densities of 40-60 kg/metre squared, thus greatly exceeding MAFF recommendations (para 66 in FAWC Report).

43c) BROILER CHICKENS in intensive units (around 99% of all UK chicken production)

34 kg/square metre.

Table chickens are marketed when between approximately 2.5 and 3 kg (liveweight) so could be living eleven birds to the metre squared. Over-stocking is common.

44a) EU legislation now covers the battery hen, pigs and calves.

44b) BATTERY HENS

EU legislation requires a minimum stocking density of 450 square centimetres of cage floor space per bird (less than a sheet of A4).

44c) PIGS

From 1 January 1998 EU legislation states (quoting the first and last figures from a list of seven):

0.15 square metres for each pig where the average weight of the pigs in the group is 10 kg or less.

1.00 square metre for each pig where the average weight of the pigs in the group is more than 110kg.

NB: MAFF has issued guidelines to 'interpret' the EU legislation on pigs. Please note that the pig stalls shown on the FAWN/NSAFF video 'The Drugs Don't Work' will be outlawed from 1999 in the UK, but still in use in many other parts of the world. Farrowing crates are still legal in the UK.

44d) CALVES

a) In the UK (where veal crates are outlawed) calves may still be kept individually in stalls up to the age of eight weeks. Individual stalls must be at least as wide as the height of the calf at its withers (the top of the shoulder blade area) and as long as the calf's length, measured from the tip of the nose to the pin bone (pin bones - small bones on either side of the tail).

b) For calves kept in groups (after the age of eight weeks) the law requires: at least 1.5 square metres for each calf with a live weight of less than 150 kg, at least 2 square metres for each calf with a live weight 150 kg or more but less than 200 kg, and at least 3 square metres for each calf with a live weight of 200 kg or more.

NB: The above EU legislation is contained in the UK's The Welfare of Livestock Regulations 1994 (No. 2126), plus The Welfare of Livestock (Amendment) Regulations 1998 which made changes in the section on calves.

THE SCOPE OF THIS BOOKLET

Clearly, this booklet merely provides a 'thumbnail sketch' of the problems caused by modern farming methods in connection with antibiotic use. The subject is far ranging and highly technical. These notes are designed to open up the subject and to promote interest. The list for further reading on page 21 is, again, far from comprehensive, but FAWN/NSAFF hope it will be helpful.

Appendix - Evidence of Resistance is Emerging

Recent research has added new weight to the Soil Association's campaign for a ban on all growth promoting antibiotics, writes Richard Young.

Using DNA sequencing researchers at the Danish Veterinary Laboratory Service have found it is possible to determine where specific types of antibiotic resistance originate through over-use in human medicine, abuse in livestock production or a combination of the two.

So far work has concentrated on the compounds known as glycopeptides. One of them avoparcin, has been the most widely used growth promoter in pig, poultry and cattle feed; the other vancomycin, is the drug of last resort in cases of MRSA, the hospital superbug that killed 5000 people last year and left another 15,000 severely disabled. Vancomycin and avoparcin are produced from the same microorganism and have identical DNA. A bacteria that develops resistance to either one is also resistant to the other.

Already vancomycin resistance has become widespread in one group of bacteria, the enterococci. These can cause serious problems in hospital patients after operations. Vancomycin resistant enterococci (VRE) were first found in France in 1986 but have now either spread to, or developed in, most other countries. Microbiologists fear that increasing levels of VRE will eventually cause vancomycin resistance to jump to the related staphylococci species and strains like MRSA with the potential for a major public health crisis.

As previously reported in Living Earth (Nos. 194 and 195) use of avoparcin was suspended throughout the EU last year following calls from the Soil Association and campaign groups in other European countries. However, its use has continued in many non-EU countries from which we still import large quantities of poultry. Until recently specialist poultry vets like Paul McMullin, head of the British Poultry Veterinary Association have been vociferous in their calls for the reinstatement of avoparcin. They claim to be using more therapeutic antibiotics on farms, especially synthetic penicillin, now avoparcin is no longer available, This might have influenced regulators in the UK, but following the release of the new Danish evidence the intensive poultry industry has suddenly gone very quiet on this issue.

The Danish researchers first compared eight conventional and six organic poultry flocks. They found no VRE in any of the organic flocks, whereas it was present in more than half of the conventional flocks. Using the latest technology they then examined the genetic make up of VRE in animals and humans. They found that a mutation had occurred in some VRE of human origin, but in none of animal origin. This has led them to conclude, 'That animals are the primary source of vancomycin resistance genes in humans'.

Until now scientists had believed the problem came principally from the medical use of vancomycin, but the Danish researchers also point out that for every kilogramme of vancomycin used in hospitals one tonne of avoparcin has been fed to farm animals.

Problems in store.

Since the avoparcin ban many poultry producers have switched to another antibiotic called virginiamycin. Antibiotics related to this have not yet been licensed for human use, but it is hoped that a new closely-related drug called synercid, will prove effective as a lifesaving replacement for treating VRE.

However, synercid resistant enterococci have been identified from hospital patients and raw meat, even before it has come into use and it seems clear this must have come from the increasing use of virginiamycin. This shows clearly why the Soil Association wants a ban on all growth-promoting antibiotics.

Reprinted from Living Earth, issue 199, July-September 1998